Skip to main content

Advertisement

Log in

Effect of pregnancy on uterine-sparing pelvic organ prolapse repair

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

The impact of pregnancy on pelvic organ prolapse following surgical repair is not well understood. We describe five cases of pregnancy following uterine-sparing surgical treatment of pelvic organ prolapse. We analyzed the changes in women’s Pelvic Organ Prolapse Quantification (POP-Q) scores. We hypothesized there would be significant improvement in anterior and apical prolapse after surgery and no recurrence of prolapse after pregnancy.

Methods

We performed a retrospective review of the electronic medical record for cases of uterine-sparing apical suspension performed between January 2004 and December 2012 at Boston Medical Center. Student’s t-test for paired design was used to compare the change in POP-Q score at points Aa, Ba and C obtained at preoperative, postoperative and postpartum visits.

Results

Subjects in our series demonstrated significant improvement in their prolapse at all POP-Q points of interest between the pre- and postoperative visits, particularly at point C. There was a slight increase in POP-Q score from the postoperative visit to the postpartum visit, but this change was not statistically significant.

Conclusions

Our findings are consistent with previous literature, suggesting that the results of uterine-sparing apical prolapse repair are maintained after pregnancy. Women may be counseled to consider surgical prolapse repair even if they have not completed childbearing.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Wu JM, Matthews CA, Conover MM, Pate V, Jonsson FM. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014;123(6):1201–6. https://doi.org/10.1097/AOG.0000000000000286.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Fayyad AM, Siozos CS. Safety and one year outcomes following vaginally assisted laparoscopic uterine sacropexy (VALUES) for advanced uterine prolapse. Neurourol Urodyn. 2014;33(3):345–9. https://doi.org/10.1002/nau.22433.

    Article  PubMed  Google Scholar 

  3. Wilcox LS, Koonin LM, Pokras R, Strauss LT, Xia Z, Peterson HB. Hysterectomy in the United States, 1988−1990. Obstet Gynecol. 1994;83(4):549–55.

    Article  CAS  Google Scholar 

  4. Price N, Slack A, Jackson SR. Laparoscopic hysteropexy: the initial results of a uterine suspension procedure for uterovaginal prolapse. BJOG. 2010;117(1):62–8. https://doi.org/10.1111/j.1471-0528.2009.02396.x.

    Article  PubMed  Google Scholar 

  5. Rahmanou P, White B, Price N, Jackson S. Laparoscopic hysteropexy: 1- to 4-year follow up of women postoperatively. Int Urogynecol J. 2014;25(1):131–8. https://doi.org/10.1007/s00192-013-2209-5.

    Article  PubMed  Google Scholar 

  6. Lewis CM, Culligan P. Sacrohysteropexy followed by successful pregnancy and eventual reoperation for prolapse. Int Urogynecol J. 2012;23(7):957–9. https://doi.org/10.1007/s00192-011-1631-9.

    Article  PubMed  Google Scholar 

  7. Pandeva I, Mistry M, Fayyad A. Efficacy and pregnancy outcomes of laparoscopic single sheet mesh sacrohysteropexy. Neurourol Urodyn. 2017;36(3):787–93. https://doi.org/10.1002/nau.23026.

    Article  PubMed  Google Scholar 

  8. Balsak D, Eser A, Erol O, Deniz Altintas D, Aksin S. Pregnancy and vaginal delivery after sacrohysteropexy. Case Rep Obstet Gynecol. 2015;2015:305107. https://doi.org/10.1155/2015/305107.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hefni M, El-Toukhy T. Sacrospinous cervico-colpopexy with follow-up 2 years after successful pregnancy. Eur J Obstet Gynecol Reprod Biol. 2002;103(2):188–90.

    Article  Google Scholar 

  10. Maher CF, Carey MP, Murray CJ. Laparoscopic suture hysteropexy for uterine prolapse. Obstet Gynecol. 2001;97(6):1010–4.

    CAS  PubMed  Google Scholar 

  11. Albowitz M, Schyrba V, Bolla D, Schoning A, Hornung R. Pregnancy after a laparoscopic sacrohysteropexy: a case report. Geburtshilfe Frauenheilkd. 2014;74(10):947–9.

    Article  CAS  Google Scholar 

  12. Busby G, Broome J. Successful pregnancy outcome following laparoscopic sacrohysteropexy for second degree uterine prolapse. Gynecol Surg. 2010;7:271–3.

    Article  Google Scholar 

  13. Jefferis H, Price N, Jackson S. Pregnancy following laparoscopic hysteropexy-a case series. Gynecol Surg. 2017;14(1):16. https://doi.org/10.1186/s10397-017-1017-.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Barranger E, Fritel X, Pigne A. Abdominal sacrohysteropexy in young women with uterovaginal prolapse: long-term follow up. Am J Obstet Gynecol. 2003;189(5):1245–50.

    Article  Google Scholar 

  15. Szymanowksi P, Szepienic W, Stuwczynski K, Gruszecki P. Cesarean section after laparoscopic hysteropexy with Richardson’s lateral repair and Burch operation—case report. Int J Surg Case Rep. 2019;59:185–9.

    Article  Google Scholar 

  16. Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175(1):10–7.

    Article  CAS  Google Scholar 

  17. Rogers RG, Nolen TL, Weidner AC, et al. Surgical outcomes after apical repair for vault compared with uterovaginal prolapse. Obstet Gynecol. 2018;131(3):475–83. https://doi.org/10.1097/AOG.0000000000002492.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Carramão S, Auge AP, Pacetta AM, Duarte E, Ayrosa P, Lemos NL, et al. A randomized comparison of two vaginal procedures for the treatment of uterine prolapse using polypropylene mesh: hysteropexy versus hysterectomy. Rev Col Bras Cir. 2009;36(1):65–72.

    Article  Google Scholar 

  19. Blandon RE, Bharucha AE, Melton LJ 3rd, Schleck CD, Babalola EO, Zinsmeister AR, et al. Incidence of pelvic floor repair after hysterectomy: a population-based cohort study. Am J Obstet Gynecol. 2007;197(6):664.e 1–7.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

TM Adegoke: Manuscript writing, manuscript editing.

O Vragovic: Data management, data analysis, manuscript editing.

CD Yarrington: Manuscript editing.

JR Larrieux: Project development, project management, data collection, manuscript editing.

Corresponding author

Correspondence to Tejumola M. Adegoke.

Ethics declarations

Conflicts of interest

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Presentations

Successful Pregnancy and Outcomes after Sacrohysteropexy for Uterine Prolapse, International Continence Society, 48th Annual Meeting, Philadelphia, PA, August 28–31, 2018

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Adegoke, T.M., Vragovic, O., Yarrington, C.D. et al. Effect of pregnancy on uterine-sparing pelvic organ prolapse repair. Int Urogynecol J 31, 657–662 (2020). https://doi.org/10.1007/s00192-019-04179-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-019-04179-2

Keywords

Navigation